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NPI Code Detail

MEDICARE: HALEY HOLT PT, DPT

MEDICARE: HALEY HOLT PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1568058980
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEY HOLT PT, DPT
Provider Business Mailing Address
First Line : 182 REMINGTON DR
Second Line :
City : BARDSTOWN
State : KY
Zip : 40004-2267
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 134 HEARTLAND DR
Second Line :
City : ELIZABETHTOWN
State : KY
Zip : 42701-2778
Country : US
Telephone Number : 270-769-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2020
Last Update Date : 12/20/2020

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